Presentation fraktur distal radius, fraktur styloid ulna free download as powerpoint presentation. Pdf pins and plaster treatment of comminuted fractures. This metaanalysis compares functional, clinical, and radiologic outcomes after operative vs nonoperative treatment of distal radial fractures in adults. The end of the distal radius typically shifts down toward the palm side in this type of fracture. Distal radius fractures broken wrist orthoinfo aaos. Operative vs nonoperative treatment of distal radius. Distal radius fracture an overview sciencedirect topics. It also occurs in young men with high velocity, injury. Intraarticular lesions in distal fractures of the radius. Patient reported pain and disability following a distal radius. Pediatric forearm and distal radius fracturesbernstein.
Mcqueen introduction classification epidemiology risk factors assessment treatment complications references introduction fracture of the distal radius is the most common fracture encountered by orthopaedic trauma surgeons. The treatment of distal radius fractures summary of recommendations the following is a summary of the recommendations in the aaos clinical practice guideline, the treatment of distal radius fractures. The ligament lesions should also be kept in mind when early mobilization of the distal fracture of the radius is considered. Conservative followup of severely displaced distal radial. Distal radius fracture, volar plate, pronator quadratus, radius, ellis plating, volar bartons fracture, buttress plate. Falls and motor vehicle collisions lead to increased risk for this type of fracture. The bone that is usually broken is called the radius. Different modalities of distal end radius fracture treatment.
The earliest accurate description of distal radius fractures was made by pouteau, as reported by peltier. Fracture of the distal radius and ulna jama jama network. Distal radius fractures are those which by definition occur about one inch from the end of the bone. The open wound was irrigated and dressed, the extremity was splintered, and the patient was given tetanus toxoid and tetracycline hydrochloride.
This retrospective, casecontrol study included postmenopausal women who had sustained a distal radial fracture fracture group, n 110 and postmenopausal women with no history of fracture control group, n 95. Fracture of the distal end radius constitutes one of the most common skeletal injuries treated by the orthopedic surgeon. Early prognostic factors in distal radius fractures in a. Despite the high incidence of distal radius fractures, around 2032 per 10,000 personyear 1, 2, many aspects in distal radius fracture management remain a subject of debate. The treatment of pediatric patients with an angulated distal radius fracture due to reasons such as late presentation or malpositioned healing fracture is unclear. Hutchinson fracture, fracture of radial styloid, is not shown and is best seen on frontal or oblique view. In fact, we have found only one case reported in the english language medical literature. Factors associated with oneyear outcome after distal radial. The ulnar styloid fracture should always be repaired. Prevention of reduction loss is the main issue in conservative treatment. Fully revised and expanded, with new illustrations and radiographs and new chapters on the distal radioulnar joint, late complications and future fracture techniques, no orthopaedic surgeon can be without this comprehensive and complete guide to the treatment of what are remarkably complex. These common fractures usually occur when significant force is applied to the distal radial metaphysis. F ractures of the distal end of the radius are common injuries, comprising 12% to 17% of all fractures.
The scope of this guideline is specifically limited to acute distal radius fractures. A distal radius fracture almost always occurs about 1 inch from the end of the bone. Out of the total number of cases n412 for fracture distal end radius, 5012% cases were managed with cast, 9122%with percutaneous fixation with kwire, 98 with external fixature, 78. Pdf distal radius fracture outcomes and rehabilitation. Treatment of distal radius fractures in patients of a younger than osteoporotic age is complex, because they often are the result of a highenergy trauma and have intraarticular fractures and associated injuries. There are many treatment options for a distal radius fracture. Presentation fraktur distal radius, fraktur styloid ulna. As the incidence of distal radius fractures increases, so too does the importance of this classic volume. Incidence fractures of the distal end radius represent approximately 16% of all fractures treated by orthopaedic. Fractures of the distal ulna associated with fracture of the distal radius evan d. Distal radius fractures are the most common upper limb fractures and account for approximately one. Presence or absence of intraarticular involvement 2. As yet no fracture classification exists that predicts outcome.
Distal radial fracture radiology reference article. Defining displacement thresholds for surgical intervention for distal. No correlation was found between specific fracture type and pattern of ligament injury. Download full thesis topics for ms dnb orthopaedics degree orthodnb. Modality of treatment for the distal end radius fracture dr bhuvnesh chaturvedi, dr sk irfan ali, dr sumit krishna abstract fracture of the distal end of radius is one of the most common fractures.
Roentgenograms made with the patient in anteroposterior and lateral positions showed severely comminuted fractures of the distal radius and ulna with shortening of the extremity fig 1. Axial shortening of the radius by less than 3 mm, designated grade 0, was considered acceptable. Distal radius fracture wrist fracture johns hopkins. Management of distal radial fractures is a controversial topic, with poor reported outcomes in up to 30% of cases and a wide variety of treatment options such as closed reduction and pop cast, internal fixation, external fixation and percutaneous pin fixation in many configurations. Displaced distal radius fractures are usually treated with closed reduction and casting. The aim of this study is to investigate the morphological characteristics of distal radius diepunch fracture drdpf with different types, based on the threecolumn theory. Clinical outcome and evaluation of patients with distal. Ae, drawings show normal distal radius in lateral projection with dorsal surface to right a, colles fracture b, smith fracture c, dorsal barton fracture d, and volar barton fracture e. Utility of distal forearm dxa as a screening tool for. Thirty to forty years ago the distal radial fractures were considered benign and conservative treatment was the rule. More than 70 000 distal radial fractures occur each year. Please fax initial evaluation and progress notes to 815.
There are around 120,000 fractures per year in the united kingdom and 607,000 annually in the united states1,2 with a. This is in particular true for a reliable and reproducible classification, the definition of an acceptable reduction and when to operate a patient with a distal radius fracture 3, 4. Pdf a study of management of intraarticular fractures. A distal radius fracture, also known as wrist fracture, is a break of the part of the radius bone which is close to the wrist. Refracture of distal radius and hardware repair in the. Ppt distal radius fractures powerpoint presentation.
Home buy feat download full thesis topics for ms dnb orthopaedics degree. Distal radius fractures are very common yet controversy exists regarding which. Distal radius fractures have an incidence of approximately 1. While the isolated fractures of proximal or distal radius are very common injuries in adults and account to 14% and 18% of all extremity fractures the simultaneous ipsilateral fractures of proximal and distal end of radius are quite uncommon. Distal radius fractures can be reset either with surgery open reduction or without it closed reduction. Simultaneous fractures of proximal and distal end of. Material and method this prospective randomized study consisted of a total number of 30 patients with intraarticular fractures of the distal end of the radius divided randomly into two groups a and b, treated by external fixation group a and volar plating group b, in. Dorsal support is provided best by placing the pegs inclined in a proximalvolar to distal dorsal direction in the lateral plane and by. In younger people, these fractures typically occur during sports or a motor vehicle collision.
Distal radius fracture orif rehabilitation protocol kelly holtkamp, m. Fractures of the bilateral distal radius and scaphoid. These, according to their displacement or tracing of the. Volar plating in distal end radius fractures article pdf available in journal of datta meghe institute of medical sciences university 111 june 2016 with 145 reads how we measure reads. Good or excellent functional results occurred in 96% of their patients. Additionally, as part of the information sent home to the participants in this study. Symptoms include pain, bruising, and rapidonset swelling. Orif of intraarticular distal radius fracture with druj instability 26. The wrist joint, part of the complex articular network that begins at the forearm and ends at the distal. Introduction distal radius fracture represent approximately one sixth of all fractures there are three main peaks of fracture distribution,children aged 514 years,male aged under 50 years and females over the age of 40 years distal radius fractures occur through the distal metaphysis of the radius may involve articular surface frequently.
Management of distal radius fractures a new concept of. The incidence of mdrf appears to be greater when the fracture is treated with cast immobilization, with a historical incidence of approximately 24. Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Pdf volar plating in distal end radius fractures and its. Distal radial fractures are a heterogeneous group of fractures that occur at the distal radius and are the dominant fracture type at the wrist. This article discusses the recovery process for both approaches, plus the pain management tactics that can be used for all patients. Morphological characteristics of different types of distal. Download full thesis topics for ms dnb orthopaedics degree. Fractures of the distal end of the radius in young adults.
Each chapter offers a comprehensive guide to the diagnosis and treatment of a specific fracture, including possible complications. Surgical correction of malunited fractures of the distal. Fractures of the distal ulna associated with fracture of. Distal radius and ulnar fractures musculoskeletal key. In this paper, we report the case of a young man who sustained highenergy, unstable, displaced distal radius fractures along with displaced scaphoid fractures.
Grade 1 included fractures with 3 to 5 mm of shortening. It occurs in middle aged and elderly women commonly. A seventythree yearold female had a previous history of distal radius fracture with repair by open reduction and internal fixation. She underwent open reduction and fixation of the distal radius fracture, and current radiographs are shown in figure b. To describe the new ideal method from classifying distal radius fractures. A fracture with more than 5 mm of radial shortening at the druj was termed grade 2. Kaushal a, patel j, katariya j, usdadia s k, kalathia c, clinical outcome and evaluation of patients with distal end radius fractures operated with volar plate and. Classification, the definition of an acceptable reduction and indications for surgery in distal radius fracture management are still subject of debate. Classification and treatment of distal radius fractures. Pins and plaster treatment of comminuted fractures of the distal end of the radius.
A new method for classifying distal radius fracture. The break can occur in many different ways, however. Distal radius fracture orif rehabilitation protocol. Atlas of distal radius fractures free pdf download. Distal radius fractures are the most common long bone fracture. Distal radial fractures can be seen in any group of patients and there is a bimodal age and sex.
Fractures of distal end radius are classified on the basis of. This usually makes for a distinct drop in the wrist where the longer part of the radius. The end of the bone nearest the wrist is called the distal end. A fracture of the lower end of the radius to 1 inch from the articular surface, in which the lower fragment and the carpus were displaced forwards in relation to the forearm. Perempuan, 42 tahun dengan nyeri pergelangan tangan kanan akibat terjatuh ketika mengenderai motor. Wide arrays of techniques have been described including closed reduction, percutaneous fixation and open methods of. A fracture of the distal radius is one of the commonest skeletal injuries treated by the orthopaedic surgeon. Pdf fractures of distal radius account for up to 20% of all fractures treated in emergency department. We present two cases females 64 and 56 years old with ipsilateral fractures of radial head and distal end of radius due to a fall. Chondral and ligamentous lesions were frequent and may explain poor outcomes after seemingly wellhealed distal fractures of the radius.
Modality of treatment for the distal end radius fracture. Distal radius fractures a free powerpoint ppt presentation displayed as a flash slide show on id. It may result from an impact to the back of the wrist, such as falling on a bent wrist. One of the most common distal radius fractures is a colles fracture, in which the broken fragment of the radius tilts upward.